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The Amateur Abortionists

Imagine a stay-at-home mom who can do an abortion. Or a college student. Imagine she knows how to administer local anesthesia, has the medicines to induce miscarriage, can dilate a cervix, scrape a uterus. Imagine a group — with no medical training — performing dozens of abortions a week, in secret, at great risk to themselves, their families and the women they serve.

That is the story of Jane, an underground group in Chicago that carried out thousands of abortions between 1969 and 1973, when abortion was illegal. It’s a story of code names and safe houses, a story of women taking control of their lives and teaching other women to do the same.

Abortion providers and the women they serve now fear that such an underground service may again become necessary. Abortion remains legal, but one conservative justice has just joined the Supreme Court and many are concerned that another will follow. This month the president signed a bill to cut funding to Planned Parenthood and other providers. Many states have enacted laws that make obtaining an abortion exceedingly difficult: About 90 percent of counties have no abortion clinics. In many areas, the procedure is nearly as inaccessible as it was in the days of Jane.

Back then, if a woman was pregnant and didn’t want to be, doctors would not help her. Abortion was a felony in 49 states. Many “back alley” abortionists could not be trusted. What to do? Call Jane.

In 1965, a University of Chicago student, Heather Booth, then 19, helped a friend’s sister find a doctor willing to do an abortion. “I was told she was nearly suicidal,” Ms. Booth told me. “I viewed it not as breaking the law, but as acting on the Golden Rule. Someone was in anguish, and I tried to help her.”

Ms. Booth was eventually deluged by so many similar pleas for help that she “saw the need to set up some kind of system.” By 1969, she had enlisted a group of women who formed the Abortion Counseling Service of Women’s Liberation. They advertised in student and underground newspapers: “Pregnant? Need help? Call Jane.” (Why “Jane”? One member just liked “sweet names.”)

By 1970, Jane was referring two dozen women a week to a few willing doctors for abortions. Callers left a message on an answering machine. “Callback Jane” would collect information and pass it on to “Big Jane,” who would supply an address — “the front” — where patients would receive counseling. Eventually they’d be taken to a different address — “the place” — such as a member’s home or a motel room, where a doctor would induce miscarriage or perform a surgical abortion. Patients were sometimes blindfolded so that they couldn’t identify who’d helped them. Each was sent home with antibiotics and instructions for follow-up care.

Soon, it was not only college students who called. Many patients were already mothers, many of them poor, some of them abused. The Janes — all of them women — took careful notes on each caller and held weekly meetings to discuss safety. They were troubled by the male abortionists’ tendency to shame patients and the procedure’s high cost ($500 to $1,000).

Then, in 1971, the group discovered that one of the abortionists was not, as he’d claimed, a doctor. But he was performing up to 20 abortions a day and was “more skilled than a doctor who performed only a few abortions a year,” writes Laura Kaplan, a former Jane member, in her book, “The Story of Jane.” The women realized, “If he can do it, then we can do it, too.”

One of the Janes persuaded him to teach her. Within months she had learned the procedure and soon trained others. The Janes were able to cut ties with back alley abortionists, dispense with blindfolds and lower the price to $100, with poor women paying less.

Only about four of the 100 or so women who joined Jane ever became skillful enough to perform surgical abortions. The others mostly answered calls, found safe apartments and assisted by sterilizing instruments and changing bedsheets. They acted as counselors, chauffeurs, nurses. No woman is known to have died at the hands of the Jane abortion providers. One Chicago obstetrician, who had agreed to provide follow-up visits to Jane patients, attested that these practitioners had a safety rate roughly the same as that of the legal clinics then operating in New York.

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In 1972, the police raided an apartment where Jane operated. Three patients waiting for abortions were taken to a hospital. Seven Jane members were arrested, among them a high school English teacher, several housewives with young children, and a student who was about to adopt a baby. In the police van, one removed from her purse a stack of 3-by-5 cards with contact information for women who’d called for help. They ripped off the corners with the patients’ names and addresses, and swallowed them.

The “Abortion Seven” were indicted. But before their case went to trial, the Supreme Court legalized abortion in the 1973 Roe v. Wade decision. The charges were dropped. Jane disbanded.

Ms. Booth is now an organizer with the consulting group Democracy Partners. “We will never go back underground,” she said. “Women and men assume that abortion will be available, that women can determine when or whether to have a child. That change is enormous.”

And yet abortion restrictions are once again so widespread that some activists are preparing for a modern-day service like Jane. Elizabeth Ziff, a member of an “underground feminist group,” is one of them. “They — this administration — are coming for all of it, the morning-after pill, birth control, abortion, all of it,” said Ms. Ziff, who is also a singer and guitarist for the feminist rock band Betty. “Women will suffer if we aren’t willing to take radical steps. And that includes learning how to perform abortions.”

But the situation for women seeking abortions and the activists who might help them is today far different from that of the Jane era. Charlotte Taft, a former director of the Abortion Care Network, said no one should “unravel a coat hanger,” especially now that “medication can create abortion far into a pregnancy.”

A woman who wishes to end a pregnancy up to 10 weeks, when most abortions happen, can get pills from a doctor — a combination of mifepristone and misoprostol — and miscarry at home. If she cannot arrange or afford an appointment with a doctor, there is another way, though it is risky and illegal. The medications can be ordered online and taken with instructions available from groups like the International Women’s Health Coalition — but the drugs aren’t always from safe sources, and several women have been prosecuted for doing this.

And what if surgery is required? Dr. Paul Blumenthal, a professor of obstetrics and gynecology at Stanford University School of Medicine, points out that in developing countries, laypeople are trained to do many procedures normally performed by doctors in the West, including C-sections. “You can train anybody to do just about anything,” he said. “Would I figure out a way to have a safe house somewhere? Would I teach? I might.”

No woman wants an abortion from a rock musician or the mom down the street. Abortion is a normal medical procedure and belongs in the mainstream of health care, safe, legal and accessible. But if that is no longer the case, women will call for it anyway, as they always have, and there’s no doubt that modern-day Janes will answer, ready to help.

Kate Manning is the author of the novel “My Notorious Life,” about a 19th-century midwife.